Published 15 July 2008, doi:10.1136/bmj.a258Cite this as: BMJ 2008;337:a258
Research
Relation of iron and red meat intake to blood pressure: cross sectional epidemiological study
Ioanna Tzoulaki, lecturer in epidemiology1, Ian J Brown, research assistant1, Queenie Chan, senior research officer1, Linda Van Horn, professor of preventive medicine2, Hirotsugu Ueshima, professor of medicine3, Liancheng Zhao, professor of epidemiology4, Jeremiah Stamler, professor emeritus2, Paul Elliott, professor1, for the International Collaborative Research Group on Macro-/Micronutrients and Blood Pressure
Correspondence to: I Tzoulaki I.Tzoulaki@imperial.ac.uk
Objective To investigate associations of dietary iron (total, haem, and non-haem), supplemental iron, and red meat with blood pressure.
Design Cross sectional epidemiological study.
Setting 17 population samples from Japan, China, the United Kingdom, and the United States participating in the international collaborative study on macro-/micronutrients and blood pressure (INTERMAP).
Participants 4680 adults aged 40-59.
Main outcome measure Average of eight blood pressure readings.
Results In multiple linear regression analyses dietary total iron and non-haem iron were consistently inversely associated with blood pressure. With adjustment for potential non-dietary and dietary confounders, dietary total iron intake higher by 4.20 mg/4.2 MJ (2 SD) was associated with –1.39 mm Hg (P<0.01) lower systolic blood pressure. Dietary non-haem iron intake higher by 4.13 mg/4.2 MJ (2 SD) was associated with –1.45 mm Hg (P<0.001) lower systolic blood pressure. Differences were smaller for diastolic blood pressure. In most models haem iron intake from food was positively, non-significantly associated with blood pressure. Iron intake from combined diet and supplements yielded smaller associations than dietary iron alone. Red meat intake was directly associated with blood pressure; 102.6 g/24 h (2 SD) higher intake was associated with 1.25 mm Hg higher systolic blood pressure. Associations between red meat and blood pressure persisted after adjustment for multiple confounders.
Conclusion Non-haem iron has a possible role in the prevention and control of adverse blood pressure levels. An unfavourable effect of red meat on blood pressure was observed. These results need confirmation including in prospective studies, clinical trials, and from experimental evidence on possible mechanisms.
Research
Relation of iron and red meat intake to blood pressure: cross sectional epidemiological study
Ioanna Tzoulaki, lecturer in epidemiology1, Ian J Brown, research assistant1, Queenie Chan, senior research officer1, Linda Van Horn, professor of preventive medicine2, Hirotsugu Ueshima, professor of medicine3, Liancheng Zhao, professor of epidemiology4, Jeremiah Stamler, professor emeritus2, Paul Elliott, professor1, for the International Collaborative Research Group on Macro-/Micronutrients and Blood Pressure
Correspondence to: I Tzoulaki I.Tzoulaki@imperial.ac.uk
Objective To investigate associations of dietary iron (total, haem, and non-haem), supplemental iron, and red meat with blood pressure.
Design Cross sectional epidemiological study.
Setting 17 population samples from Japan, China, the United Kingdom, and the United States participating in the international collaborative study on macro-/micronutrients and blood pressure (INTERMAP).
Participants 4680 adults aged 40-59.
Main outcome measure Average of eight blood pressure readings.
Results In multiple linear regression analyses dietary total iron and non-haem iron were consistently inversely associated with blood pressure. With adjustment for potential non-dietary and dietary confounders, dietary total iron intake higher by 4.20 mg/4.2 MJ (2 SD) was associated with –1.39 mm Hg (P<0.01) lower systolic blood pressure. Dietary non-haem iron intake higher by 4.13 mg/4.2 MJ (2 SD) was associated with –1.45 mm Hg (P<0.001) lower systolic blood pressure. Differences were smaller for diastolic blood pressure. In most models haem iron intake from food was positively, non-significantly associated with blood pressure. Iron intake from combined diet and supplements yielded smaller associations than dietary iron alone. Red meat intake was directly associated with blood pressure; 102.6 g/24 h (2 SD) higher intake was associated with 1.25 mm Hg higher systolic blood pressure. Associations between red meat and blood pressure persisted after adjustment for multiple confounders.
Conclusion Non-haem iron has a possible role in the prevention and control of adverse blood pressure levels. An unfavourable effect of red meat on blood pressure was observed. These results need confirmation including in prospective studies, clinical trials, and from experimental evidence on possible mechanisms.
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